Walking and hypertension: greater reductions in subjects with higher baseline systolic blood pressure following six months of guided walking.

Simona Mandini,Francesco Conconi,Giovanni Grazzi,Elisa Mori,Jonathan Myers,Gianni Mazzoni

doi:10.7717/peerj.5471

Simona Mandini, Francesco Conconi + Show 4 more

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https://doi.org/10.7717/peerj.5471

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Abstract

BackgroundThe aim of the study was to assess the effects of walking on the blood pressure in sedentary adults with differing degrees of systolic blood pressure (SBP).MethodsA total of 529 subjects with SBP above 120 mmHg were enrolled. Blood pressure, body weight, body mass index, waist circumference and walking speed were determined at enrolment and after six months. Walking sessions were supervised by exercise physiologists.ResultsThe weekly walking time of the subjects completing the project was uniform and reached 300 minutes by the second month. 56% of participants completed the 6 months intervention (182 women 59.6 ± 9.0 years, and 114 men, 65.4 ± 8.6 years) 27 had a baseline SBP >160 mm Hg, 35 between 150–159, 70 between 140–149, 89 between 130–139 and 75 between 120–129 mmHg. Following six months of supervised walking, SBP was significantly reduced in all subgroups (p < 0.001), with the greatest reduction (−21.3 mmHg) occurring in subjects with baseline SBP >160 and the smallest reduction (−2.6 mmHg) occurring in subjects with baseline SBP of 120–129 mmHg. Diastolic blood pressure, body weight, body mass index and waist circumference were also significantly reduced following the walking intervention (p < 0.001). These reductions were nearly identical within the various groups.DiscussionIn a large group of sedentary adults with varying degrees of SBP, 6 months of supervised walking elicited a marked reduction in systolic blood pressure with the largest reductions in pressure occurring in individuals with higher baseline SBP.

Highlights

Hypertension is the most common, costly, and preventable cardiovascular disease risk factor (Pescatello et al, 2015) and is a major public health concern worldwide requiring intensive prevention and treatment management programs (Ettehad et al, 2016; Redon et al, 2016; Whelton et al, 2017)
This has confounded the ability to analyze in detail the effect of physical activity on hypertension, given that blood pressure reductions appear to be more pronounced in subjects with more severe hypertension (Murtagh et al, 2015; Börjesson et al, 2016)
The 2017 AHA guidelines (Whelton et al, 2017) state that hypertension begins at systolic blood pressure (SBP) >130 mmHg and SBP of 120–129 mmHg is considered elevated blood pressure. Taking into consideration these guidelines (Whelton et al, 2017) and the significant reductions in systolic and diastolic blood pressure among subjects who followed programs of regular walking (Murtagh et al, 2015; Börjesson et al, 2016) our study has considered the effects of six months of guided walking on the blood pressure of 5 groups of subjects with baseline systolic pressure respectively between 120 and 130 mmHg, 130 and 140, 140 and 150, 150 and 160 and above 160 mmHg

Summary

Introduction

Hypertension is the most common, costly, and preventable cardiovascular disease risk factor (Pescatello et al, 2015) and is a major public health concern worldwide requiring intensive prevention and treatment management programs (Ettehad et al, 2016; Redon et al, 2016; Whelton et al, 2017). Previous studies on the effects of aerobic exercise on blood pressure have in most cases included a mix of normotensive and hypertensive subjects (Murtagh et al, 2015; Börjesson et al, 2016). 56% of participants completed the 6 months intervention (182 women 59.6 ± 9.0 years, and 114 men, 65.4 ± 8.6 years) 27 had a baseline SBP >160 mm Hg, 35 between 150–159, 70 between 140–149, 89 between 130–139 and 75 between 120–129 mmHg. Following six months of supervised walking, SBP was significantly reduced in all subgroups (p < 0.001), with the greatest reduction (−21.3 mmHg) occurring in subjects with baseline SBP >160 and the smallest reduction (−2.6 mmHg) occurring in subjects with baseline SBP of 120–129 mmHg. Diastolic blood pressure, body weight, body mass index and waist circumference were significantly reduced following the walking intervention (p < 0.001). In a large group of sedentary adults with varying degrees of SBP, 6 months of supervised walking elicited a marked reduction in systolic blood pressure with the largest reductions in pressure occurring in individuals with higher baseline SBP

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